Published Date: July 22, 2026
The Centers for Medicare and Medicaid Services (CMS) is expanding access to certain GLP-1 medications for people with Medicare Part D through Medicare GLP-1 Bridge starting July 1, 2026. The program will continue through Dec. 31, 2027.
Medicare GLP-1 Bridge will operate outside of Medicare Part D plan coverage and use a central processor to manage prior authorization, claims processing, and pharmacy payment.
NOTE: This is a CMS-managed program. Highmark is sharing this information as a service to our members and our provider community.
The Medicare GLP-1 Bridge is for patients who are not eligible to receive a GLP-1 drug through their Part D plan and do not have type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease.
For more information, go here.
Foundayo® (tablets), Wegovy® (injection and tablets), and Zepbound® (KwikPen® injection).
Pharmacies will collect a $50 copay amount from the eligible beneficiary, and the central processor will process payment to the pharmacy.
Using this form, prior authorization requests should be submitted electronically at CoverMyMeds.com. Providers can also use 800-530-2404 to fax the form.